I am an imposter in a white coat. I’m not sure if anyone knows yet, I hope I am good at hiding it. It’s a well-kept secret amongst all medical students. In the hospital, I am at the bottom. I know the least and have the least power. Most patients don’t realize this and look up to me like I’m an all-knowing, wise muse or something of that nature. Sometimes, I seem to play it off well. I fooled them all! They think I’m actually smart! Then the attending asks me a basic question during rounds, and I’m back at baseline thinking I’m stupid and incompetent once again.
This is a cycle medical students experience once they get to the wards. We put on the short white coat that we were once so proud to wear on the day we matriculated into medical school. Now, after completing most of my clinical rotations, I find every excuse not to wear it. It’s not just because I always seem to spill a drop of coffee onto my sleeve every damn morning (of all colors, why white?), but also because I literally feel like I don’t deserve to wear something that presumes such greatness and authority. With it carries a huge responsibility, and I just don’t want to disappoint. Heaven forbids a medical student being a disappointment to society. We’d rather get hemorrhoids and drown in our own blood from our anus.
Every medical student is pretending to be smarter than they are and less stressed than they really are. We study way more than we claim we are, have much less fun than we brag about on Facebook, and are much more insecure than we put ourselves out to be. I know this to be true because I am guilty of this. I’ve been faking it till I make it since the beginning of time. It’s contagious, and it’s toxic.
Why do we put ourselves through this misery? For me, it’s because I have these unrealistic expectations of perfection. We’re a unique group of people, chosen from the top of our class from an elite group of students from each college. We’re used to achieving and striving to be the best at what we do, whether it’s academics, music, sports, art, or drinking. When you put a group of similar high-achieving, neurotic people together, you raise the bar exponentially, as well as individual expectations and competition. Our sense of self-worth, confidence, and thus degree of happiness then plummets. The medical school environment does not alleviate this disastrous outcome, especially since the root cause is us, the students.
It’s not really our fault either. From the beginning, we have been drilled to succeed and rewarded for our academic (and non-academic) achievements. That’s how we got here to begin with. I’m sure some of us did so at the expense of someone else. Not everyone could win first place in that piano competition, be valedictorian, or captain of the soccer team. Some of us are so used to success, that we don’t know how to handle failure. In medical school, many of us experienced our first failures, and many don’t know how to cope with that. We forget what made us truly happy, and why we came to medical school in the first place. It’s easy to get lost in our self-destructive thoughts: “I’m not good enough for this. I don’t deserve to be here. Why is (insert name) so much better at biochem than me? Why did (insert name) get a higher USMLE Step 1 score than me even though I studied so much longer? How come (insert name) has time to publish all these research papers, when I don’t have any? …”
You can tell how vicious this process of thinking can get. I know, because I have been through this.
To provide a sense of comfort to other medical students who feel the same as me, you’re not alone. I’m just as insecure about my abilities as the rest of you despite my determined attempts at hiding it. I hope that one day, this will all be behind me and I will truly be a competent physician who doesn’t have to pretend anymore. I hope that I will stop comparing myself to other “more competent” people who seem to have everything put together. I sincerely make an effort to try to only compete with myself, but some people make that extremely difficult when they are advertising their 250s in public and posting their publications and other vast achievements on social media. (And even after I get rid of Facebook, somehow I still hear about it.)
I genuinely try to feel happy for them, and part of me truly is proud, but there’s always this other side of me that feels jealously and shame towards myself — a nagging voice asking, “Why couldn’t that be you?”
I know I can’t avoid all of this thinking process completely, but I have taken steps to at least calm the waves down. I focus on the positive things in my life and have stopped placing unrealistic expectations on myself. I hang out with similar-minded people who make me happy and don’t patronize others. I reconnect with my old friends who I have seemingly ignored for the past three years. I rediscover the real things in life that make me happy — family, friends, my dog, nature, Ellen Degeneres, and wine.
Don’t get me wrong, I still study my ass off, but am not obsessed about it anymore. When I put on my white coat, I think about how privileged I am to have this incredible and rare opportunity to do so. Instead of feeling stupid after not knowing an answer, I think of it as a positive learning experience — why would I even be here if I knew all the answers anyway? I try to avoid people who can’t stop talking about how many clerkships they honored, how many clinics they started in a third world country, and how many attendings are so impressed by their knowledge of the purine synthesis pathway. I’ll be friends with them once they get over their own insecurities and stop having to constantly prove how “good” they are.
We’re all in the same boat here. Let’s keep the sea as calm as possible until we land.
Serena Zhou-Talbert is a family medicine physician.